Enrolling for Veterans Healthcare

Congress has required that after October 1, 1998, most veterans must be enrolled to receive VA hospital and outpatient care. Congress has also expanded the range of medical services that enrolled veterans may receive. Veterans may apply for enrollment at any time, and our Veterans Service Office will help facilitate those claims. Here are some common questions about enrollment and benefits.

The number of Veterans who can be enrolled in the health care program is determined by the amount of money Congress gives VA each year. Since funds are limited, the VA sets up Priority Groups to make sure that certain groups of Veterans are able to be enrolled before others.

Once you apply for enrollment, your eligibility will be verified. Based on your specific eligibility status, you will be assigned a Priority Group. The Priority Groups range from 1-8 with 1 being the highest priority for enrollment. Some Veterans may have to agree to pay co-pay to be placed in certain Priority Groups.

You may be eligible for more than one Enrollment Priority Group. In that case, VA will always place you in the highest Priority Group that you are eligible for. Under the Medical Benefits Package, the same services are generally available to all enrolled Veterans. VA determines your eligibility for VA’s comprehensive medical benefits package through our patient enrollment system, which is based on Priority Groups from 1 through 8.

Enrollment Priorities

Priority Group 1:

Veterans with VA Service-connected disabilities rated 50% or more.

Veterans assigned a total disability rating for compensation based on unemployability.

Priority Group 2:

Veterans with VA Service-connected disabilities rated 30% or 40%.

Priority Group 3:

Veterans who are former POWs.

Veterans awarded the Purple Heart Medal.

Veterans awarded the Medal of Honor.

Veterans whose discharge was for a disability incurred or aggravated in the line of duty.

Veterans with VA Service-connected disabilities rated 10% or 20%.

Veterans awarded special eligibility classification under Title 38, U.S.C., § 1151, “benefits for individuals disabled by treatment or vocational rehabilitation.”

Priority Group 4:

Veterans receiving increased compensation or pension based on their need for regular Aid and Attendance or by reason of being permanently Housebound.